115例股静脉临时导管停用原因分析

Analysis on the causes necessitating removal of the temporary femoral vein catheters in 115 cases

目的：探讨股静脉临时导管在初次血液透析患者中使用的临床意义及影响其使用的相关因素。方法：选取皖南医学院第一附属医院血液净化中心2014年2~6月使用股静脉临时导管进行血液透析的新入的CKD5期患者115例。对上述115例患者进行随访。记录透析前血清白蛋白、血红蛋白及血肌酐值,并记录静脉导管置入时间、停用时间及停用原因。依据停用原因分为常规停用组（内瘘启用）及非常规停用组（非内瘘启用）。结果：常规停用组与非常规停用组在男女比例、年龄大小及原发病方面无明显差异（P〉0.05）。常规停用组开始血液透析时的血红蛋白及血清白蛋白值均高于非常规停用组（P〈0.01）;虽然常规停用组开始透析时血肌酐平均值低于非常规停用组,但无统计学意义（P〉0.05）。结论：绝大多数股静脉临时导管可以正常使用到内瘘成熟启用后拔出。患者的营养状况可能对其静脉导管的使用寿命有影响。

Objective：To investigate the clinical significance of temporary femoral venous access device in patients undergoing initial hemodialysis and re- lated factors necessitating removal of the cannulation. Methods ：115 patients with chronic kidney disease （CKD） at stage 5 undergoing initial hemedialysis in our hospital during February and Jane of 2014 were included, and allocated to planned device removal group（ fistula enabling dialysis） and non-planned device removal group （ non - fistula enabling dialysis）. All patients were followed up and maintained regarding the levels of serum albumin, hemoglobin and serum creatinine before dialysis, the time of venous catheter placement and catheter removal as well as causes for necessary removal of the access device. Results ： The two groups were not significant with regard to the ratio of genders, ages and presence of primary disease （ P 〉 0.05 ）. However, the planned de- vice removal group had higher levels of hemoglobin and serum albumin upon dialysis （P 〈 0.01 ）, and the serum creatinine level remained no significance between the two groups （ P 〉 0.05 ）. Conclusion ： Most femoral venous access device can be removed till maturing of permanent fistula, yet nutritional status of patients niay affect the service life of the catheter.